Aluminium Phosphide Poisoning: Clinical Profile and Outcome of Patients Admitted in a Tertiary Care Hospital

Muhammad Arshad Qureshi; Shahid  Nadeem; Tufail  Ahmad; Fariha  Tariq; Humaira  Rehman; Altaf Pervez Qasim

doi:10.29054/apmc/2018.104

Muhammad Arshad Qureshi Professor / HOD Pharmacology, Sahiwal Medical College, Sahiwal
Shahid Nadeem Assistant Professor Forensic Medicine Sahiwal Medical College, Sahiwal
Tufail Ahmad Assistant Professor Forensic Medicine Rai Medical College, Sargodha
Fariha Tariq Assistant Professor Forensic Medicine Sahiwal Medical College, Sahiwal
Humaira Rehman Demonstrator Forensic Medicine Sahiwal Medical College, Sahiwal
Altaf Pervez Qasim Professor / HOD Forensic Medicine Sahiwal Medical College, Sahiwal

DOI: https://doi.org/10.29054/apmc/2018.104

Keywords: Poisoning, Wheat Pills, Aluminium Phosphide, Clinical Profile, Outcome; Suicide

Abstract

Background: Acute poisoning is a significant health problem being the leading cause of morbidity and mortality all over the world. Poisoning due to ingestion of Aluminum Phosphide & Organophosphates is considered among the commonest poisons leading to fatal consequences. Objective: To study the clinical profile and outcome of the patients with (Wheat Pills) Aluminum Phosphide (ALP) poisoning brought to the District Head Quarter (DHQ) Teaching Hospital, Sahiwal. Setting & Duration: The study was carried out in DHQ Hospital Sahiwal (a tertiary care health institution attached with Sahiwal Medical College, Sahiwal, Pakistan) for the period of one year i.e. 1^st January, 2017 to 31^st December, 2017. Methodology: The patients above 12 years of either gender brought to the DHQ Hospital Sahiwal, with history of ingestion of (wheat pills) Aluminum phosphide; were included in study by non-probability convenient sampling. The data retrieved from the hospital record / treatment charts of the patients admitted in Accident & Emergency / Medical Units. Prior permission from the controlling authorities was also taken. The data entered in predesigned proforma for further analysis. Results: Of the total one hundred & ten patients; 94(85.45%) belonged to the younger age group 12-30 years while 65(59.1%) cases of Aluminium Phosphide poisoning were females & 45(40.9%) males. Similarly, females represented 30(27.27%) poisoning cases compared to males 16(14.54%) in the age stratum 12-20 years. Majority 48(43.63%) cases were between the age group of 21-30 years. The intake of Aluminium Phosphide with suicidal intent was found in 82(79.6%) cases. The frequent clinical features were Shock / Tachycardia observed in 32(29.1%) cases whereas 62(56.36%) patients couldn’t survive in spite of extensive resuscitation. Conclusion: Aluminium Phosphide is frequently used poison with suicidal intent especially in the younger population. Shock / Tachycardia were the most frequent clinical presentation of the patients. Mortality rate was higher in Aluminium Phosphide poisoning in spite of resuscitative measures. No antidote is available so far whereas role of magnesium sulphate and coconut oil are controversial. Recommendations: Situation could be improved by reducing the occupational exposure, resolving the conflicts leading to self-poisoning & adequate training of the medical / paramedical staff in poisoning management at the primary, secondary and tertiary care hospitals. Proper legislation is to be done for strict control on the sale of aluminium phosphide. Further research is required to find out the effective antidote in order to reduce the mortality because of aluminium phosphide poisoning.